NPI | 1013081504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA psy 21832) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 21832) |
103TF0000X Psychologist, Family (Licence: CA 21832) | |
Enumeration Date | 2006-11-17 |
Last Update Date | 2022-07-21 |