NPI | 1215062823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 756) |
Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: SC 756) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: SC 756) | |
103TH0100X Psychologist Health Service (Licence: SC 756) | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2022-07-21 |