NPI | 1164558318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 6462) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6462) |
103TF0000X Psychologist, Family (Licence: MA 6462) | |
103T00000X Psychologist (Licence: MA 6462) | |
Enumeration Date | 2007-02-24 |
Last Update Date | 2007-07-08 |