NPI | 1902003031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016577) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100489200) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2014-03-25 |