NPI | 1689709107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008988) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401002550) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2013-03-13 |