NPI | 1528194917 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY001867) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY001867) |
103TA0700X Psychologist, Adult Development & Aging (Licence: GA PSY001867) | |
Enumeration Date | 2007-02-27 |
Last Update Date | 2021-03-31 |