NPI | 1003359530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019410) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004584) |
103TC0700X Psychologist, Clinical (Licence: MI 6361001119) | |
Enumeration Date | 2016-12-01 |
Last Update Date | 2024-01-25 |