NPI | 1548564487 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS008892L) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000875) |
Enumeration Date | 2011-01-07 |
Last Update Date | 2011-01-07 |