NPI | 1164609665 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 9226522-2501) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017071) |
103TC0700X Psychologist, Clinical (Licence: NJ 5088) | |
Enumeration Date | 2008-01-28 |
Last Update Date | 2016-11-04 |