NPI | 1013385384 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: AZ 4654) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AZ 4654) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4654) | |
Enumeration Date | 2015-09-03 |
Last Update Date | 2015-09-03 |