NPI | 1285900217 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017176) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS017176) |
103TC0700X Psychologist, Clinical (Licence: CA PSY 25319) | |
Enumeration Date | 2012-03-23 |
Last Update Date | 2012-10-16 |