| NPI | 1881313377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301019152) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6351004419) |
| 103T00000X Psychologist (Licence: MI 6301019152) | |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2022-12-02 |