NPI | 1366658247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 15934) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 29899) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2007-10-12 |