NPI | 1356625081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2022015232) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2022015232) |
Enumeration Date | 2011-09-29 |
Last Update Date | 2024-04-10 |