NPI | 1306085493 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY25456) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017003-1) |
103TC0700X Psychologist, Clinical (Licence: NY 017003-1) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 017003-1) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY25456) | |
103TC0700X Psychologist, Clinical (Licence: CA PSY25456) | |
Enumeration Date | 2009-02-12 |
Last Update Date | 2015-06-15 |