NPI | 1336564970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015851) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015851) |
Enumeration Date | 2014-02-19 |
Last Update Date | 2022-12-15 |