NPI | 1093149031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DC 1001034) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05061) |
Enumeration Date | 2013-08-27 |
Last Update Date | 2016-09-07 |