NPI | 1568741841 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004442) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA 016169) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2024-12-24 |