NPI | 1154511103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.007944) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.007944) |
103TA0700X Psychologist, Adult Development & Aging | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2007-07-26 |
Last Update Date | 2011-09-09 |