NPI | 1548690704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361003450) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361003450) |
103TC0700X Psychologist, Clinical (Licence: MI 6301015777) | |
Enumeration Date | 2013-11-25 |
Last Update Date | 2023-10-31 |