| NPI | 1881683050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301005056) |
| Additional Taxonomies | 103TS0200X Psychologist School |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2022-02-15 |