NPI | 1255618963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5054) |
Additional Taxonomies | 101Y00000X Counselor |
103T00000X Psychologist (Licence: NC 5054) | |
Enumeration Date | 2011-11-09 |
Last Update Date | 2024-11-22 |