| NPI | 1821748914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301019015) |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-05-25 |