NPI | 1316199045 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 34186) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 18735) |
Enumeration Date | 2008-10-13 |
Last Update Date | 2011-08-22 |