NPI | 1538381157 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS008517L) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS008517L) |
103TF0200X Psychologist, Forensic (Licence: PA PS008517L) | |
Enumeration Date | 2007-05-03 |
Last Update Date | 2007-07-08 |