NPI | 1124239256 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361006445) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301010385) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2021-04-08 |