| NPI | 1962836890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019262) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6351001879) |
| 103T00000X Psychologist (Licence: MI 6301019262) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301017022) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 6301015091) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2023-06-08 |