NPI | 1457415234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017240) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017240) |
103TC0700X Psychologist, Clinical (Licence: PA PS017240) | |
Enumeration Date | 2006-12-19 |
Last Update Date | 2018-04-02 |