NPI | 1235616335 |
---|---|
Former Name | VICTORIA CHIALY SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005946) |
Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810005946) |
Enumeration Date | 2018-07-23 |
Last Update Date | 2024-02-19 |