NPI | 1912550146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME PS2493) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11176) |
Enumeration Date | 2019-07-17 |
Last Update Date | 2024-02-13 |