NPI | 1487192704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS-008794-L) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS-008794-L) |
Enumeration Date | 2017-02-07 |
Last Update Date | 2021-03-22 |