NPI | 1588659643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AL 712) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: AL 712) |
103T00000X Psychologist (Licence: AL 712) | |
Enumeration Date | 2005-09-15 |
Last Update Date | 2007-07-08 |