NPI | 1316502925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY30497) |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY30497) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2019-05-08 |