NPI | 1457907057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006015) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 027305) |
103T00000X Psychologist (Licence: DC PSY200001184) | |
Enumeration Date | 2019-08-11 |
Last Update Date | 2025-08-05 |