NPI | 1649292574 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8056) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1920) |
103TC0700X Psychologist, Clinical (Licence: MD 3446) | |
Enumeration Date | 2006-07-23 |
Last Update Date | 2007-07-08 |