NPI | 1659518629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014845) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006452) |
Enumeration Date | 2009-01-13 |
Last Update Date | 2013-07-24 |