NPI | 1144765504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018750) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05884) |
Enumeration Date | 2016-12-21 |
Last Update Date | 2021-10-25 |