| NPI | 1972728939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 6501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301014492) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2016-12-15 |