NPI | 1700967486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007083) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6301007083) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2018-06-18 |