NPI | 1336359108 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001078) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 016329) |
103TC0700X Psychologist, Clinical (Licence: VA 0810005206) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2017-04-19 |