NPI | 1972570455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005793) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: VA 0803000229) |
Enumeration Date | 2006-03-03 |
Last Update Date | 2020-01-17 |