NPI | 1912264870 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2172) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA 3257) |
Enumeration Date | 2012-04-17 |
Last Update Date | 2013-07-09 |