NPI | 1255596599 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: IA 480) |
Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: IA 480) |
103TC0700X Psychologist Clinical (Licence: IA 480) | |
103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: IA 480) | |
103TS0200X Psychologist School (Licence: IA 188488) | |
Enumeration Date | 2008-07-25 |
Last Update Date | 2008-07-25 |