NPI | 1790752517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1646) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7380) |
103T00000X Psychologist (Licence: NC 4732) | |
Enumeration Date | 2006-03-01 |
Last Update Date | 2024-10-23 |