NPI | 1003253253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004749) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014633) |
Enumeration Date | 2013-05-29 |
Last Update Date | 2024-05-17 |