| 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 |