NPI | 1295163079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37108) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8254) |
Enumeration Date | 2013-10-14 |
Last Update Date | 2016-09-06 |