NPI | 1750570602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003694) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810003694) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2015-05-12 |