| NPI | 1922302041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013979) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361000375) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2022-03-29 |