NPI | 1124638333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019131) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY61127031) |
103TC0700X Psychologist, Clinical (Licence: IN 20043621A) | |
Enumeration Date | 2020-08-03 |
Last Update Date | 2024-09-25 |