| NPI | 1972823656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014932) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301014465) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2014-05-14 |