NPI | 1639256233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2003030084) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810008022) |
103T00000X Psychologist (Licence: TX 38068) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2024-03-26 |