NPI | 1467860841 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 012720) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: CO 0318720) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2014-08-01 |