NPI | 1871762526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PR 3040) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PR 3040) |
Enumeration Date | 2008-02-27 |
Last Update Date | 2011-09-08 |