| NPI | 1891458709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6352000490) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 6352000490) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-05-13 |