NPI | 1881201788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007660) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6362008870) |
Enumeration Date | 2020-09-25 |
Last Update Date | 2023-06-29 |