NPI | 1043536709 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05244) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4323) |
Enumeration Date | 2010-04-20 |
Last Update Date | 2022-09-06 |