NPI | 1205965944 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1271) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY8486) | |
Enumeration Date | 2007-03-05 |
Last Update Date | 2015-02-18 |