NPI | 1558849174 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IA 101709) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 101709) |
101YM0800X Counselor, Mental Health (Licence: NE 5324) | |
Enumeration Date | 2018-08-06 |
Last Update Date | 2020-10-30 |