NPI | 1457562563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 588) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 3800) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2007-07-08 |