NPI | 1174592380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4292) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2868) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2017-11-26 |