NPI | 1104481977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6352000211) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301017422) |
Enumeration Date | 2019-05-07 |
Last Update Date | 2020-07-16 |