NPI | 1619010766 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012546) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2007-07-08 |