NPI | 1528418928 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5019) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NC 5019) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5019) | |
Enumeration Date | 2016-06-16 |
Last Update Date | 2023-05-30 |