NPI | 1346727963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS018599) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 3480) |
Enumeration Date | 2018-07-26 |
Last Update Date | 2018-11-14 |