NPI | 1962435784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00991) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IA 00991) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2019-12-31 |