| NPI | 1790765170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301009314) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2023-07-11 |