NPI | 1669073508 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019146) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS019146) |
Enumeration Date | 2020-11-06 |
Last Update Date | 2020-11-06 |