NPI | 1346418050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MD 1350) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 1350) |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MD 1350) | |
Enumeration Date | 2008-02-15 |
Last Update Date | 2010-09-23 |