NPI | 1275645665 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 63010103394) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C-00012) |
103TC0700X Psychologist Clinical (Licence: MI 63010103394) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2017-02-06 |