| NPI | 1841252137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1100) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1100) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301012453) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-07-08 |