| NPI | 1861544801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8495) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301008887) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.006822) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |