NPI | 1851003719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: LA DC860062) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: LA DC860062) |
171M00000X Case Manager/Care Coordinator (Licence: LA DC860062) | |
Enumeration Date | 2022-12-21 |
Last Update Date | 2022-12-21 |