| NPI | 1801297718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10220) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015955) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2019-02-21 |