| NPI | 1881060390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013922) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TF0000X Psychologist, Family (Licence: MI 6301013922) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MI 6301013922) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013922) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2018-05-23 |