NPI | 1730769175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39857) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 32514) |
Enumeration Date | 2021-04-09 |
Last Update Date | 2023-06-24 |