| NPI | 1861514283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301006075) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MI 6301006075) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301006075) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301006075) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301006075) | |
| 103TH0100X Psychologist, Health Service (Licence: MI 6301006075) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301006075) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2007-07-08 |