NPI | 1942678883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04976) |
Additional Taxonomies | 103T00000X Psychologist |
103TC0700X Psychologist, Clinical (Licence: DC 1000570) | |
103TC0700X Psychologist, Clinical (Licence: VA 0810004181) | |
Enumeration Date | 2015-09-09 |
Last Update Date | 2024-01-04 |