NPI | 1649629577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000306) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003579) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2016-06-10 |