NPI | 1851430326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 54962) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 34279) |
Enumeration Date | 2007-02-05 |
Last Update Date | 2016-09-14 |