NPI | 1477921724 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.7311) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7311) |
Enumeration Date | 2015-09-03 |
Last Update Date | 2021-10-07 |