NPI | 1770864225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 29384) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019255) |
103TC0700X Psychologist, Clinical (Licence: NM psy1668) | |
Enumeration Date | 2011-08-29 |
Last Update Date | 2022-03-28 |