NPI | 1275116667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 6191) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 40229) |
Enumeration Date | 2021-05-03 |
Last Update Date | 2024-05-08 |