NPI | 1568584977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 25629) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: TX 25629) |
103TF0200X Psychologist, Forensic (Licence: TX 25629) | |
Enumeration Date | 2007-04-05 |
Last Update Date | 2007-07-08 |