NPI | 1275847469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36243) |
Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: TX 36243) |
Enumeration Date | 2010-07-30 |
Last Update Date | 2016-08-09 |