| NPI | 1831629971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301018839) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: SC 1734) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2023-11-27 |