| NPI | 1770202871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361008026) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361008026) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2025-01-08 |