NPI | 1154830503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6351004325) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016761) |
Enumeration Date | 2017-09-28 |
Last Update Date | 2023-05-03 |