NPI | 1063781359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY10225) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA Psy10225) |
103T00000X Psychologist (Licence: MS 20-250) | |
Enumeration Date | 2011-12-15 |
Last Update Date | 2018-10-09 |