NPI | 1316133234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8759) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 1243) |
Enumeration Date | 2007-09-25 |
Last Update Date | 2011-10-31 |