NPI | 1750811717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000895) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005029) |
103TC0700X Psychologist, Clinical (Licence: MD 05281) | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2017-06-13 |