NPI | 1225111057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012416) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
103TC0700X Psychologist, Clinical (Licence: MI 6301012416) | |
Enumeration Date | 2006-10-23 |
Last Update Date | 2018-10-07 |