NPI | 1538390513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37623) |
Additional Taxonomies | 101Y00000X Counselor |
103TC0700X Psychologist, Clinical (Licence: CA 28185) | |
Enumeration Date | 2009-08-07 |
Last Update Date | 2018-03-17 |