NPI | 1184965469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38742) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004401) |
Enumeration Date | 2013-03-11 |
Last Update Date | 2022-08-04 |