NPI | 1578711768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36599) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2008-09-03 |
Last Update Date | 2017-03-27 |