NPI | 1003810912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801034974) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401003601) |
103TP0814X Psychologist, Psychoanalysis | |
Enumeration Date | 2005-06-08 |
Last Update Date | 2011-10-17 |