NPI | 1043075674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports (Licence: CA psy12925) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA psy12925) |
Enumeration Date | 2024-02-13 |
Last Update Date | 2024-02-13 |