NPI | 1245449008 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 3-1095) |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 3-1095) |
103TR0400X Psychologist, Rehabilitation (Licence: TX 3-1095) | |
Enumeration Date | 2007-05-21 |
Last Update Date | 2011-07-15 |