NPI | 1578872834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3709-57) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 24387) |
Enumeration Date | 2010-10-04 |
Last Update Date | 2024-12-31 |