NPI | 1811419526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1509) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: LA 1509) |
Enumeration Date | 2017-07-13 |
Last Update Date | 2024-02-15 |