NPI | 1124492681 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000078) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810002702) |
Enumeration Date | 2015-11-20 |
Last Update Date | 2015-11-20 |