| NPI | 1982969218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361001550) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014578) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2022-04-05 |