NPI | 1316321409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 1255) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PR 1255) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: PR 1255) | |
Enumeration Date | 2015-07-17 |
Last Update Date | 2015-07-17 |