NPI | 1306296454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY30872) |
Additional Taxonomies | 103T00000X Psychologist |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2016-06-20 |
Last Update Date | 2020-10-28 |