| NPI | 1912053802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012381) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012381) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2018-02-07 |