NPI | 1578786224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32884) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS015660) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2007-07-08 |