NPI | 1558743799 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA 230536779) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7316) |
103TC0700X Psychologist, Clinical (Licence: CO PSY.0004330) | |
Enumeration Date | 2015-06-24 |
Last Update Date | 2025-04-21 |