NPI | 1215369004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01543) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 10021) |
Enumeration Date | 2013-08-02 |
Last Update Date | 2023-09-18 |