NPI | 1245378421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1166) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1166) |
103TF0000X Psychologist, Family (Licence: LA 1166) | |
Enumeration Date | 2007-02-01 |
Last Update Date | 2011-11-16 |