NPI | 1871992578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019119) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: PS019119) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PS019119) | |
Enumeration Date | 2014-08-19 |
Last Update Date | 2020-10-27 |