NPI | 1003164070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY23615) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY23615) |
103TC0700X Psychologist, Clinical (Licence: CA PSY23615) | |
103TH0100X Psychologist, Health Service (Licence: CA PSY23615) | |
Enumeration Date | 2012-08-24 |
Last Update Date | 2012-08-24 |