NPI | 1962051425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017972) |
103TC0700X Psychologist, Clinical (Licence: MI 6301019156) | |
Enumeration Date | 2019-09-08 |
Last Update Date | 2023-03-28 |