NPI | 1154543882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY17768) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6886) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2007-07-08 |