NPI | 1629324694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3562) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 68 020159) |
Enumeration Date | 2012-07-27 |
Last Update Date | 2016-05-24 |