NPI | 1396854022 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810000290) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701002492) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2007-09-07 |