NPI | 1306371786 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3594) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 3594) | |
Enumeration Date | 2017-04-24 |
Last Update Date | 2023-04-24 |