NPI | 1316612419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6362009347) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361007891) |
Enumeration Date | 2021-08-11 |
Last Update Date | 2024-04-18 |