| NPI | 1982266607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301017867) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017867) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2021-11-15 |