NPI | 1194087247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22492) |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: PSY 22492) |
Enumeration Date | 2012-06-14 |
Last Update Date | 2015-09-16 |