NPI | 1386269025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NM 0936) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NM 0936) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2020-06-09 |