NPI | 1154796480 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4882) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4882) |
Enumeration Date | 2015-12-11 |
Last Update Date | 2020-12-22 |