NPI | 1699835611 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361003125) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301008519) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2021-12-03 |