| NPI | 1811666951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6362009389) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6362009389) |
| Enumeration Date | 2021-09-11 |
| Last Update Date | 2022-08-18 |