NPI | 1932202173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1147) |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: AL 1147) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2016-02-29 |