NPI | 1316282817 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11259) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH16649) |
Enumeration Date | 2012-12-10 |
Last Update Date | 2022-09-09 |