NPI | 1558789925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2018017437) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 03033) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2023-09-01 |