NPI | 1922403567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1651) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 3211) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 3211) | |
Enumeration Date | 2014-10-24 |
Last Update Date | 2022-11-21 |