NPI | 1952133910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 40615) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY004804) |
Enumeration Date | 2024-08-19 |
Last Update Date | 2025-03-25 |