| NPI | 1821522640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007108) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015825) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-10-04 |