NPI | 1134771629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10505) |
Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY10505) |
Enumeration Date | 2019-07-15 |
Last Update Date | 2024-11-06 |