NPI | 1407134273 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2341) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 005477) |
103TC0700X Psychologist, Clinical (Licence: CA 30930) | |
Enumeration Date | 2011-07-28 |
Last Update Date | 2023-09-21 |