NPI | 1023441755 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9689) |
Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY9689) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY9689) | |
Enumeration Date | 2013-08-16 |
Last Update Date | 2018-06-25 |