| NPI | 1982159646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016766) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 003306) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |