NPI | 1639247893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904000674) |
106H00000X Marriage & Family Therapist (Licence: VA 0904000674) | |
Enumeration Date | 2006-12-04 |
Last Update Date | 2007-07-08 |