| NPI | 1922468123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361001547) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201001532) |
| 103T00000X Psychologist (Licence: MI 6361001547) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2026-06-25 |