NPI | 1205416112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA PSY31112) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY31112) |
103TF0200X Psychologist, Forensic (Licence: AK 155806) | |
Enumeration Date | 2021-04-13 |
Last Update Date | 2021-04-14 |