NPI | 1487898763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361003059) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013832) |
103TC0700X Psychologist, Clinical (Licence: MI 6301013832) | |
Enumeration Date | 2009-04-30 |
Last Update Date | 2022-08-05 |