NPI | 1245731447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MA 7609-PY-PR) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 012590) |
Enumeration Date | 2018-02-22 |
Last Update Date | 2018-02-22 |