NPI | 1962775619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008231) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7222) |
Enumeration Date | 2012-02-10 |
Last Update Date | 2015-01-08 |