NPI | 1376750281 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012132) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301012132) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2012-12-17 |