NPI | 1548579949 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9253) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9253) |
103TC0700X Psychologist, Clinical (Licence: IN 20043734B) | |
Enumeration Date | 2010-10-02 |
Last Update Date | 2024-01-26 |