NPI | 1891028254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015606) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301015606) |
Enumeration Date | 2009-09-16 |
Last Update Date | 2015-07-29 |