NPI | 1679630222 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005162) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009310) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2025-10-02 |