NPI | 1548865124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 40454) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 40454) |
103TS0200X Psychologist, School | |
Enumeration Date | 2020-12-02 |
Last Update Date | 2024-12-10 |