NPI | 1467480798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3447) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 3447) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2012-12-02 |