NPI | 1215385273 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 1889) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PR 1889) |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PR 1889) | |
Enumeration Date | 2016-06-01 |
Last Update Date | 2016-06-01 |