NPI | 1407374275 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010519) |
Additional Taxonomies | 261QM0801X |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2017-08-31 |
Last Update Date | 2021-07-05 |