NPI | 1881250330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38953) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38953) |
103TC0700X Psychologist, Clinical (Licence: MD 06581) | |
Enumeration Date | 2019-05-10 |
Last Update Date | 2023-11-05 |