NPI | 1619241536 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3605) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CO 3605) |
Enumeration Date | 2012-02-24 |
Last Update Date | 2019-08-21 |