NPI | 1316096456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 004941) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 10147) |
103TC0700X Psychologist, Clinical (Licence: MA 9688) | |
Enumeration Date | 2007-01-09 |
Last Update Date | 2025-01-17 |