NPI | 1154384923 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO PY 01441) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MO PY 01441) |
103TR0400X Psychologist, Rehabilitation (Licence: MO PY 01441) | |
Enumeration Date | 2006-04-11 |
Last Update Date | 2007-07-10 |