NPI | 1720657547 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 6572) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 6572) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC 1680) | |
103T00000X Psychologist | |
Enumeration Date | 2021-06-24 |
Last Update Date | 2024-10-28 |