NPI | 1922468123 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361001547) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009423) |
225X00000X Occupational Therapist (Licence: MI 5201001532) | |
Enumeration Date | 2016-03-01 |
Last Update Date | 2022-12-01 |