NPI | 1033357785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7240) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY7240) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY7240) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY7240) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY7240) | |
Enumeration Date | 2009-02-02 |
Last Update Date | 2015-11-18 |