NPI | 1245886993 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11628) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11628) |
103T00000X Psychologist | |
Enumeration Date | 2019-08-16 |
Last Update Date | 2022-08-26 |