| NPI | 1861791980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012502) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 6065) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2024-07-01 |