NPI | 1093067589 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008426) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071008426) |
103TF0000X Psychologist, Family (Licence: IL 071008426) | |
Enumeration Date | 2012-10-08 |
Last Update Date | 2013-01-16 |