| NPI | 1861066003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019343) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6351004511) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2024-05-14 |