NPI | 1760561708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016586) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS016887) |
103T00000X Psychologist (Licence: CA PSY21208) | |
Enumeration Date | 2006-11-02 |
Last Update Date | 2024-09-14 |