NPI | 1053583120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8603) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 851) |
103TC0700X Psychologist, Clinical (Licence: FL PY5819) | |
Enumeration Date | 2008-03-29 |
Last Update Date | 2013-04-04 |