NPI | 1255627279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3519) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3519) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01245) | |
Enumeration Date | 2011-06-28 |
Last Update Date | 2025-01-16 |