NPI | 1720203771 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3246) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 3246) |
103TF0000X Psychologist, Family (Licence: NC 3246) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 3246) | |
103TH0004X Psychologist, Health (Licence: NC 3246) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 3246) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: NC 3246) | |
Enumeration Date | 2007-04-16 |
Last Update Date | 2010-06-07 |