NPI | 1023394723 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 3203) |
Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PR 3203) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: PR 3203) | |
Enumeration Date | 2011-10-25 |
Last Update Date | 2011-10-25 |