NPI | 1366805426 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 01798) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 01798) |
Enumeration Date | 2016-04-05 |
Last Update Date | 2016-04-05 |