NPI | 1780633578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 9153) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 016505) |
103TC0700X Psychologist, Clinical (Licence: CA PSY 24209) | |
Enumeration Date | 2006-05-09 |
Last Update Date | 2023-04-27 |