NPI | 1265756597 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22425) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY22425) |
103K00000X Behavior Analyst (Licence: CA PSY22425) | |
103T00000X Psychologist (Licence: CA PSY22425) | |
Enumeration Date | 2010-03-15 |
Last Update Date | 2011-10-13 |