NPI | 1093031320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8267) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8267) |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2010-04-12 |
Last Update Date | 2022-07-21 |