| NPI | 1891824561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008967) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: MI 6301008967) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |