NPI | 1235593849 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: DC 1940) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810004998) |
103T00000X Psychologist (Licence: MD 03531) | |
Enumeration Date | 2016-04-09 |
Last Update Date | 2020-01-07 |