NPI | 1104043645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 20176) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 6407) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2007-07-08 |