| NPI | 1922359629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4590) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015147) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2017-12-01 |