NPI | 1174688063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05227) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05227) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05227) | |
Enumeration Date | 2006-12-22 |
Last Update Date | 2023-02-13 |