NPI | 1093849028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PR 2240) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PR 002240) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2023-07-03 |