NPI | 1073859211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05649) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004666) |
Enumeration Date | 2012-12-17 |
Last Update Date | 2022-12-02 |