NPI | 1750618138 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015353) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018209-1) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2018-11-29 |