NPI | 1114152352 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4158) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: MA 4158) |
Enumeration Date | 2009-05-18 |
Last Update Date | 2009-12-15 |