NPI | 1356557011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 3927) |
Additional Taxonomies | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: PR 25781) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2021-12-20 |