NPI | 1437234002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2004013225) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1243) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2007-10-10 |