NPI | 1902922339 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 3664) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 3664) |
103T00000X Psychologist (Licence: MD 3664) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: MD 3664) | |
Enumeration Date | 2007-03-21 |
Last Update Date | 2015-01-05 |