NPI | 1366826604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018406) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2015-07-16 |
Last Update Date | 2020-01-21 |