NPI | 1891851051 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003074) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY003074) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003074) | |
103TC0700X Psychologist, Clinical (Licence: MD 04127) | |
Enumeration Date | 2006-12-29 |
Last Update Date | 2010-10-07 |