NPI | 1205117082 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY31062) |
Additional Taxonomies | 103T00000X Psychologist |
103TC1900X Psychologist, Counseling (Licence: CA PSY31062) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2011-09-07 |
Last Update Date | 2022-04-20 |