NPI | 1316345333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016124) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301016124) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301016124) | |
Enumeration Date | 2014-12-08 |
Last Update Date | 2014-12-08 |