NPI | 1376199711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 06171) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MD 06171) |
Enumeration Date | 2019-08-12 |
Last Update Date | 2022-08-22 |