NPI | 1194097147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 3284) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 11845) |
Enumeration Date | 2012-02-07 |
Last Update Date | 2023-10-12 |