NPI | 1023680675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6436) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008144) |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2021-07-13 |
Last Update Date | 2023-10-05 |