NPI | 1033474994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: CA 2013042) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 2013042) |
103T00000X Psychologist | |
103TE1100X Psychologist, Exercise & Sports (Licence: CA 2013042) | |
225C00000X Rehabilitation Counselor | |
Enumeration Date | 2012-07-06 |
Last Update Date | 2022-04-29 |