NPI | 1174734610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 18640) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 33662) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2013-05-28 |