| NPI | 1922510791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361008001) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6361008001) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6361008001) | |
| 103TH0004X Psychologist, Health (Licence: MI 6361008001) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6361008001) | |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2025-11-17 |