NPI | 1619105582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY3783) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM PSY-2025-0099) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2025-09-10 |