NPI | 1164584835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38116) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100524800) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2024-02-08 |