NPI | 1134478274 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8564) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY 8564) |
103TF0000X Psychologist, Family (Licence: FL PY 8564) | |
103TH0004X Psychologist, Health (Licence: FL PY 8564) | |
Enumeration Date | 2012-09-05 |
Last Update Date | 2012-09-05 |