NPI | 1881700961 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 1796) |
Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 1796) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2007-07-10 |