| NPI | 1780212704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018382) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005514) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |