NPI | 1316379704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3457) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 29708) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2022-04-20 |