NPI | 1164858866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25502) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY25502) |
103T00000X Psychologist (Licence: CA PSY25502) | |
Enumeration Date | 2013-09-25 |
Last Update Date | 2024-04-29 |