NPI | 1922130467 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801069850) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301011930) |
Enumeration Date | 2007-03-11 |
Last Update Date | 2020-08-28 |