NPI | 1295888261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1502) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OR 1502) |
103TA0700X Psychologist, Adult Development & Aging (Licence: OR 1502) | |
Enumeration Date | 2007-01-20 |
Last Update Date | 2021-08-26 |