NPI | 1124232699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 01232) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 01232) |
103TH0004X Psychologist, Health (Licence: MO 01232) | |
Enumeration Date | 2007-05-10 |
Last Update Date | 2019-10-10 |