NPI | 1457404519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7372) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 7372) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 7372) | |
Enumeration Date | 2007-01-19 |
Last Update Date | 2016-04-28 |