NPI | 1588784292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS-004161-L) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS-004161-L) |
103TS0200X Psychologist, School (Licence: PA PS-004161-L) | |
Enumeration Date | 2007-03-29 |
Last Update Date | 2016-07-10 |