NPI | 1548356082 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: CT 001319) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 001319) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 001319) | |
103T00000X Psychologist (Licence: CT 001319) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2007-07-08 |