NPI | 1396155628 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361001765) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016366) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-05-08 |
Last Update Date | 2020-04-30 |