NPI | 1134493406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 26276) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: TX 36101) |
103TC0700X Psychologist, Clinical (Licence: TX 36101) | |
Enumeration Date | 2012-03-03 |
Last Update Date | 2022-10-21 |