NPI | 1609836105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 03975) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301006723) |
Enumeration Date | 2006-03-27 |
Last Update Date | 2016-10-17 |