NPI | 1477872000 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017889) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 7569599-2501) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA TPS030297) | |
Enumeration Date | 2010-05-21 |
Last Update Date | 2016-09-02 |