NPI | 1104053933 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9180) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 9180) |
Enumeration Date | 2009-06-19 |
Last Update Date | 2011-06-09 |