NPI | 1124150867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38636) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY9130) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2022-06-23 |