NPI | 1417948993 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4848) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY4848) |
Enumeration Date | 2005-11-02 |
Last Update Date | 2019-12-17 |