NPI | 1306128442 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018194) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 22025) |
Enumeration Date | 2011-09-14 |
Last Update Date | 2022-08-04 |