NPI | 1013295625 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5710) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 22662) |
Enumeration Date | 2011-07-31 |
Last Update Date | 2021-02-15 |