NPI | 1386773497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810002069) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03004) |
103TC0700X Psychologist, Clinical (Licence: MA 7003) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810002069) | |
103T00000X Psychologist (Licence: VA 0810002069) | |
Enumeration Date | 2007-03-05 |
Last Update Date | 2010-06-30 |