NPI | 1316183775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 3297) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017372) |
Enumeration Date | 2009-01-06 |
Last Update Date | 2009-08-18 |