NPI | 1285939355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013004) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013004) |
Enumeration Date | 2011-01-20 |
Last Update Date | 2023-01-24 |