NPI | 1285886663 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7075) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: FL py7075) |
103TP2701X Psychologist, Group Psychotherapy (Licence: FL py7075) | |
Enumeration Date | 2008-10-16 |
Last Update Date | 2017-04-07 |