NPI | 1841319043 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 754) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 918) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2007-07-08 |