| NPI | 1851632277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005093) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015074) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2022-10-03 |