NPI | 1922380401 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005433) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1674) |
103TC0700X Psychologist, Clinical (Licence: DC PSY1001216) | |
Enumeration Date | 2011-09-12 |
Last Update Date | 2016-12-05 |