NPI | 1194156927 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301015779) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: MI 6301015779) |
Enumeration Date | 2013-12-04 |
Last Update Date | 2013-12-04 |