NPI | 1215147673 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NV PY0742) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 002497) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2023-10-02 |