NPI | 1235390352 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7111) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PY7111) |
103TH0004X Psychologist, Health (Licence: PY7111) | |
Enumeration Date | 2008-06-20 |
Last Update Date | 2020-06-03 |