NPI | 1831309640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 21708) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 6463) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2007-07-08 |