NPI | 1295854859 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY12332) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY12332) |
103T00000X Psychologist (Licence: CA PSY12332) | |
Enumeration Date | 2007-03-28 |
Last Update Date | 2012-04-13 |