NPI | 1093811010 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY11802) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS008896L) |
Enumeration Date | 2006-09-16 |
Last Update Date | 2024-10-25 |