| NPI | 1851962187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301019543) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 6351004656) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2024-09-18 |