NPI | 1316528789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1693) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 32123) |
Enumeration Date | 2021-04-17 |
Last Update Date | 2022-04-06 |