NPI | 1003958661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY21400) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY21400) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2018-02-06 |