NPI | 1679886857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY0004393) |
Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY0004393) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY0004393) | |
Enumeration Date | 2010-07-16 |
Last Update Date | 2010-07-16 |