NPI | 1679053441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL PY7275) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7275) |
103TF0000X Psychologist, Family (Licence: FL PY7275) | |
Enumeration Date | 2018-08-20 |
Last Update Date | 2018-08-21 |