NPI | 1235120650 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MO R0218) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO R0218) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: MO R0218) | |
103TB0200X Psychologist Cognitive & Behavioral | |
103TF0000X Psychologist Family | |
103T00000X Psychologist | |
103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
103TC1900X Psychologist Counseling | |
Enumeration Date | 2005-11-03 |
Last Update Date | 2007-07-08 |