NPI | 1396765327 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301014861) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2000175012) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2020-11-25 |