NPI | 1225122062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32604) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 19487) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2016-05-31 |