NPI | 1982813150 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 001276) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MT 316) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2012-10-03 |