NPI | 1134986490 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019379) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005709) |
Enumeration Date | 2024-03-04 |
Last Update Date | 2024-11-14 |