NPI | 1356490767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV PYT170323) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 5570) |
103T00000X Psychologist (Licence: AL 1625) | |
Enumeration Date | 2007-01-09 |
Last Update Date | 2023-10-31 |