NPI | 1154615664 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003092) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8962) |
Enumeration Date | 2011-06-01 |
Last Update Date | 2011-06-01 |