NPI | 1316296650 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 005481) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 8791112-2501) |
Enumeration Date | 2012-08-31 |
Last Update Date | 2024-07-05 |