NPI | 1154619161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018852) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301018852) |
Enumeration Date | 2011-07-12 |
Last Update Date | 2024-07-29 |