NPI | 1538178116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WV 61219) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 2695) |
Enumeration Date | 2006-08-05 |
Last Update Date | 2019-07-26 |