NPI | 1407051360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY3763) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY3763) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY3763) | |
103TF0000X Psychologist, Family (Licence: FL PY3763) | |
103TF0200X Psychologist, Forensic (Licence: FL PY3763) | |
103TS0200X Psychologist, School (Licence: FL SS321) | |
Enumeration Date | 2007-06-19 |
Last Update Date | 2023-07-19 |