NPI | 1265846851 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017466) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100527500) |
Enumeration Date | 2014-06-11 |
Last Update Date | 2014-06-11 |