NPI | 1023203023 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 36147) |
Additional Taxonomies | 103TF0000X Psychologist Family (Licence: TX 36147) |
Enumeration Date | 2007-09-12 |
Last Update Date | 2013-06-04 |