NPI | 1356752158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301016414) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2014-05-14 |
Last Update Date | 2022-07-21 |