NPI | 1215567425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY4196) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CO 0004196) |
Enumeration Date | 2020-01-16 |
Last Update Date | 2022-08-18 |