NPI | 1770235079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5155) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NC 5155) |
Enumeration Date | 2022-01-19 |
Last Update Date | 2022-01-19 |