NPI | 1255378386 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003274) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20263) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003274) | |
Enumeration Date | 2006-05-31 |
Last Update Date | 2020-04-26 |