NPI | 1184901720 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 1304) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OK 1304) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: ND 458) | |
Enumeration Date | 2011-11-10 |
Last Update Date | 2023-09-05 |