| NPI | 1790038230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007640) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015912) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2021-09-14 |