| NPI | 1942700612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019492) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY0005741) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY0005741) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2024-08-27 |