| NPI | 1942657077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NV PY1056) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301018907) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2022-09-28 |