NPI | 1053756908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05117) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA psy26474) |
Enumeration Date | 2013-05-06 |
Last Update Date | 2020-09-12 |