| NPI | 1992578439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301019503) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-07-10 |