NPI | 1215075866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36495) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY-624) |
103TC0700X Psychologist, Clinical (Licence: CA 23120) | |
Enumeration Date | 2007-02-02 |
Last Update Date | 2014-12-20 |