NPI | 1821419912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6361002922) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6361002922) |
103K00000X Behavior Analyst | |
103T00000X Psychologist (Licence: MI 6361002922) | |
Enumeration Date | 2013-12-17 |
Last Update Date | 2020-12-17 |