| NPI | 1811495039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301015205) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MI 6301015205) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301015205) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |