NPI | 1235828542 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019876) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS019876) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS019876) | |
Enumeration Date | 2023-05-03 |
Last Update Date | 2023-05-03 |