NPI | 1710253182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003162) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CT 003162) |
103TC0700X Psychologist, Clinical (Licence: NY 019350) | |
103TC0700X Psychologist, Clinical (Licence: CT 003264) | |
Enumeration Date | 2012-03-29 |
Last Update Date | 2024-08-20 |