| NPI | 1871523233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013862) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY7088) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-11-21 |