NPI | 1265766562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9446) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2009-09-21 |
Last Update Date | 2011-11-15 |