NPI | 1487901609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009153) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.009063) |
101YP2500X Counselor, Professional (Licence: IL 178.007955) | |
Enumeration Date | 2012-08-07 |
Last Update Date | 2015-10-28 |