NPI | 1245240597 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7040) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7040) |
103TA0700X Psychologist, Adult Development & Aging (Licence: MA 7040) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: MA 7040) | |
Enumeration Date | 2006-08-09 |
Last Update Date | 2012-07-13 |