NPI | 1659694974 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2011032874) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 0712010118186) |
Enumeration Date | 2010-03-02 |
Last Update Date | 2023-11-07 |