NPI | 1124544648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.009923) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.009923) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2020-01-09 |