NPI | 1538784012 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019229) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301019229) |
Enumeration Date | 2020-06-10 |
Last Update Date | 2023-08-22 |