| NPI | 1982852547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007240) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013046) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2023-09-08 |