| NPI | 1902575749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007787) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6361007787) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-06-04 |