NPI | 1336271337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA 1019) |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: GA 1019) |
103T00000X Psychologist (Licence: GA 1019) | |
103TS0200X Psychologist, School (Licence: GA 1019) | |
Enumeration Date | 2007-03-12 |
Last Update Date | 2007-07-08 |