NPI | 1508345638 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0005375) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CO 0005375) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 0005375) | |
Enumeration Date | 2018-08-09 |
Last Update Date | 2022-09-16 |