NPI | 1972117703 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSYA00269) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0805002049) |
Enumeration Date | 2020-08-31 |
Last Update Date | 2020-08-31 |