| NPI | 1891041075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014713) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation (Licence: MI 6301014713) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2019-08-29 |