NPI | 1699240572 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5351) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004828) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5351) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810004828) | |
Enumeration Date | 2018-10-08 |
Last Update Date | 2018-10-08 |