NPI | 1194092270 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 03007) |
Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 03007) |
Enumeration Date | 2011-11-17 |
Last Update Date | 2011-11-17 |