NPI | 1366471484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016868) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY18504) |
103TC0700X Psychologist, Clinical (Licence: MN LP4910) | |
Enumeration Date | 2006-07-01 |
Last Update Date | 2023-08-15 |