NPI | 1831648302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3573) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2016-09-26 |
Last Update Date | 2023-08-31 |