| NPI | 1801817077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301012960) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012960) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2021-08-25 |