NPI | 1164114773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 32928) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 32928) |
Enumeration Date | 2023-05-23 |
Last Update Date | 2024-06-19 |