NPI | 1164540316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY9977) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA Psy9977) |
103T00000X Psychologist (Licence: CA Psy9977) | |
Enumeration Date | 2007-03-26 |
Last Update Date | 2007-07-08 |