NPI | 1558742692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4730) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4730) |
Enumeration Date | 2015-06-15 |
Last Update Date | 2015-06-15 |