NPI | 1568844835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004088) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1939) |
Enumeration Date | 2015-06-23 |
Last Update Date | 2025-01-04 |