NPI | 1316025604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS-005502) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS005502L) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2012-08-30 |