NPI | 1841718954 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 2072) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 095686) |
103TC0700X Psychologist, Clinical (Licence: MS 591039) | |
Enumeration Date | 2017-09-08 |
Last Update Date | 2023-05-02 |