NPI | 1245508688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: CA 25712) |
Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: CA 25712) |
103TF0000X Psychologist, Family (Licence: CA 25712) | |
Enumeration Date | 2011-12-13 |
Last Update Date | 2011-12-13 |