NPI | 1295332773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007733) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6362009202) |
Enumeration Date | 2020-10-07 |
Last Update Date | 2025-09-27 |