NPI | 1780882795 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003491) |
Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: VA 0810003491) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2012-05-04 |