NPI | 1174768584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3217) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1099) |
Enumeration Date | 2008-12-14 |
Last Update Date | 2015-07-31 |