NPI | 1780059253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015731) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015731) |
Enumeration Date | 2015-12-09 |
Last Update Date | 2019-12-06 |