NPI | 1043458904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60759292) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY22441) |
Enumeration Date | 2009-01-30 |
Last Update Date | 2018-05-01 |