NPI | 1235504655 |
---|---|
Former Name | OLIVIA TORRES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301018177) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301018177) |
Enumeration Date | 2015-12-10 |
Last Update Date | 2023-07-12 |