NPI | 1003949728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000180) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 3621) |
103TC0700X Psychologist, Clinical (Licence: VA 0810000355) | |
Enumeration Date | 2007-03-13 |
Last Update Date | 2007-07-08 |