NPI | 1316077795 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CT 002212) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CT 002212) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 002212) | |
Enumeration Date | 2007-03-06 |
Last Update Date | 2013-03-26 |