NPI | 1346730496 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810007790) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY11669) |
103TC0700X Psychologist, Clinical (Licence: PR 005804) | |
Enumeration Date | 2018-05-15 |
Last Update Date | 2025-02-03 |