NPI | 1356893812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101007156) |
Additional Taxonomies | 103T00000X Psychologist |
103TC1900X Psychologist, Counseling | |
Enumeration Date | 2016-11-01 |
Last Update Date | 2021-05-04 |