NPI | 1447759873 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT 2572) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 647) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MT 2572) | |
Enumeration Date | 2018-02-12 |
Last Update Date | 2020-08-03 |