NPI | 1114334984 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5511) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY xxx) |
Enumeration Date | 2014-07-14 |
Last Update Date | 2020-10-01 |