NPI | 1295292514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CT 001879) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 001879) |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TF0000X Psychologist, Family | |
Enumeration Date | 2019-02-22 |
Last Update Date | 2019-02-22 |