NPI | 1649568338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004422) |
Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: VA 0810004422) |
Enumeration Date | 2011-07-14 |
Last Update Date | 2025-04-09 |