NPI | 1922318393 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: WI 2893-57) |
Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: WI 2893-57) |
103TP2701X Psychologist, Group Psychotherapy (Licence: WI 2893-57) | |
Enumeration Date | 2010-10-19 |
Last Update Date | 2010-10-19 |