NPI | 1114325818 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA LEP3485) |
Additional Taxonomies | 103K00000X Behavior Analyst |
103TC1900X Psychologist, Counseling | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA LEP3485) | |
103TE1100X Psychologist, Exercise & Sports | |
103TS0200X Psychologist, School | |
Enumeration Date | 2014-12-11 |
Last Update Date | 2014-12-11 |