NPI | 1386848935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 03082) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 03082) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2021-05-14 |