NPI | 1881930899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4799) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2016035608) |
103TC0700X Psychologist, Clinical (Licence: UT 9259127-2501) | |
Enumeration Date | 2012-12-19 |
Last Update Date | 2022-01-27 |