NPI | 1073887535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY11942) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2175) |
103T00000X Psychologist (Licence: CA 25836) | |
Enumeration Date | 2012-03-01 |
Last Update Date | 2024-06-21 |