NPI | 1417380528 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B1-0001033) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015573) |
Enumeration Date | 2013-08-12 |
Last Update Date | 2015-09-26 |