NPI | 1073004248 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: AL 2144) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2018-05-23 |
Last Update Date | 2019-11-06 |