| NPI | 1962051425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017972) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301019156) | |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2023-03-28 |