NPI | 1194104893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021169) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY28758) |
Enumeration Date | 2015-05-27 |
Last Update Date | 2017-01-20 |