NPI | 1154316115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY28595) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20041623A) |
Enumeration Date | 2005-09-15 |
Last Update Date | 2021-03-08 |