NPI | 1114028461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8922) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04092) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2016-06-16 |