NPI | 1225141914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60036513) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY KY-1429) |
103TC0700X Psychologist, Clinical (Licence: CA PSY 21928) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2023-11-13 |