| NPI | 1922357557 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: MI SP0000000772488)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 2720103)  | 
| Enumeration Date | 2012-08-29 | 
| Last Update Date | 2012-08-29 |