NPI | 1528419785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 61277804) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004884) |
Enumeration Date | 2016-06-28 |
Last Update Date | 2024-07-08 |