NPI | 1053474650 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 569) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY002609) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2018-11-07 |