NPI | 1235774878 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06055) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001374) |
103TC0700X Psychologist, Clinical (Licence: AL 2136) | |
Enumeration Date | 2019-11-07 |
Last Update Date | 2022-03-25 |