NPI | 1962653642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01083) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8914) |
Enumeration Date | 2008-10-01 |
Last Update Date | 2012-02-01 |