NPI | 1184647455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301003164) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301003164) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2015-07-30 |