NPI | 1043547821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013105) |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: MI 6301013105) |
Enumeration Date | 2009-11-16 |
Last Update Date | 2022-03-03 |