NPI | 1881178747 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6351004732) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016767) |
Enumeration Date | 2018-09-17 |
Last Update Date | 2024-10-02 |