NPI | 1285094789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018352) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ SI5583) |
Enumeration Date | 2016-02-26 |
Last Update Date | 2020-10-09 |