NPI | 1124302070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 1211) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TF0000X Psychologist, Family | |
103TF0200X Psychologist, Forensic | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
Enumeration Date | 2011-10-10 |
Last Update Date | 2011-10-10 |