NPI | 1104380401 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61300930) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007722) |
103TC0700X Psychologist, Clinical (Licence: DC PSY200001564) | |
Enumeration Date | 2019-01-31 |
Last Update Date | 2024-08-01 |