NPI | 1295045318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361004588) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MI 6301014371) |
103TC0700X Psychologist, Clinical (Licence: MI 6301014371) | |
Enumeration Date | 2010-10-08 |
Last Update Date | 2020-04-30 |