NPI | 1649494576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012322) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301012322) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2022-05-25 |