NPI | 1699220053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006195) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: VA PPPS-0605906) |
Enumeration Date | 2016-08-15 |
Last Update Date | 2021-04-14 |