NPI | 1871718155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT PSY-PSY-LIC-947) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-04-13 |
Last Update Date | 2012-10-12 |