NPI | 1336673698 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA 015139) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: PA 015139) |
103TP2701X Psychologist, Group Psychotherapy (Licence: PA 015139) | |
Enumeration Date | 2017-04-13 |
Last Update Date | 2017-04-13 |