NPI | 1740557545 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1186) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018678) |
Enumeration Date | 2011-11-21 |
Last Update Date | 2014-11-12 |