| NPI | 1972388734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019777) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301019777) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2026-01-05 |