NPI | 1568686541 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME PS1197) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY002054) |
103TC0700X Psychologist, Clinical (Licence: FL PY 5523) | |
103TS0200X Psychologist, School | |
Enumeration Date | 2007-04-12 |
Last Update Date | 2022-07-21 |