NPI | 1700176948 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38265) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY60491478) |
103TC0700X Psychologist, Clinical (Licence: ID PSY203037) | |
Enumeration Date | 2011-04-08 |
Last Update Date | 2022-12-20 |