NPI | 1598346546 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007516) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
225XM0800X Occupational Therapist, Mental Health | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2021-06-14 |