NPI | 1982056693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019617) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 10393) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2024-04-11 |