NPI | 1760563837 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016112) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100430300) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2007-07-08 |