NPI | 1952562175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014653) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071009028) |
1041C0700X Social Worker, Clinical (Licence: MI 6801092352) | |
Enumeration Date | 2008-06-19 |
Last Update Date | 2020-11-06 |