NPI | 1659745958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003313) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000102) |
Enumeration Date | 2015-11-24 |
Last Update Date | 2015-11-24 |