NPI | 1366653032 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY4893) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY4893) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY4893) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2007-07-08 |