NPI | 1992042741 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-004674) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008094) |
Enumeration Date | 2013-01-14 |
Last Update Date | 2023-06-13 |