NPI | 1285658732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3657) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 2283) |
103TF0200X Psychologist, Forensic | |
103TF0200X Psychologist, Forensic | |
Enumeration Date | 2006-07-27 |
Last Update Date | 2011-09-05 |