NPI | 1184954497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36124) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36124) |
Enumeration Date | 2010-01-08 |
Last Update Date | 2012-06-20 |