NPI | 1003403015 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005825) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810006389) |
Enumeration Date | 2020-12-23 |
Last Update Date | 2023-01-30 |