NPI | 1073665410 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 048-0000917) |
Additional Taxonomies | 103T00000X Psychologist |
103TB0200X Psychologist Cognitive & Behavioral | |
103TC1900X Psychologist Counseling | |
103TC2200X Psychologist Clinical Child & Adolescent | |
103TF0000X Psychologist Family | |
103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2007-01-17 |
Last Update Date | 2020-03-16 |