NPI | 1154602167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.005696) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.005696) |
Enumeration Date | 2011-09-03 |
Last Update Date | 2011-09-03 |