NPI | 1639475387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4593) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2011-01-28 |
Last Update Date | 2018-04-25 |