NPI | 1477113132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006019) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WA TE60973740) |
103TC1900X Psychologist, Counseling (Licence: VA 0810006019) | |
Enumeration Date | 2019-06-15 |
Last Update Date | 2019-06-22 |