NPI | 1346623576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005119) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05524) |
103TC0700X Psychologist, Clinical (Licence: DC PSY1001033) | |
Enumeration Date | 2015-07-07 |
Last Update Date | 2015-07-07 |