NPI | 1285961532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014556) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013975) |
Enumeration Date | 2009-11-06 |
Last Update Date | 2023-03-13 |