NPI | 1982181863 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018723) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017473) |
Enumeration Date | 2018-07-24 |
Last Update Date | 2020-10-13 |