NPI | 1720059355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017611) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: VA 0810003505) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810003505) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017611) | |
Enumeration Date | 2006-01-31 |
Last Update Date | 2014-07-17 |