NPI | 1194409672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 07196) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008573) |
Enumeration Date | 2023-06-14 |
Last Update Date | 2025-05-13 |