| NPI | 1952562175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014653) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071009028) |
| 1041C0700X Social Worker Clinical (Licence: MI 6801092352) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-11-06 |