NPI | 1003837097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8211) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8211) |
103TP2701X Psychologist, Group Psychotherapy (Licence: MA 8211) | |
Enumeration Date | 2006-07-22 |
Last Update Date | 2007-07-08 |