| NPI | 1871894675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007094) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014548) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2021-10-27 |