| NPI | 1831489541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015898) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 2019302) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2018-08-13 |