NPI | 1427109289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017890) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH NH260) |
103TC0700X Psychologist Clinical (Licence: MA 3193) | |
Enumeration Date | 2007-01-16 |
Last Update Date | 2015-11-09 |