NPI | 1275929630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2559) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1716) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2021-05-13 |