NPI | 1770202871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361008026) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361008026) |
Enumeration Date | 2022-08-23 |
Last Update Date | 2025-01-08 |