| NPI | 1922386135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 68019264) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014769) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2013-03-06 |