NPI | 1992923502 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY 5102) |
Additional Taxonomies | 103TF0000X Psychologist Family (Licence: FL PY 5102) |
103TF0200X Psychologist Forensic (Licence: FL PY 5102) | |
103TP0016X Psychologist Prescribing (Medical) (Licence: FL PY 5102) | |
Enumeration Date | 2007-04-22 |
Last Update Date | 2007-07-08 |