NPI | 1396178448 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY31606) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY31606) |
103TC0700X Psychologist, Clinical (Licence: MA 10922) | |
Enumeration Date | 2013-08-13 |
Last Update Date | 2024-04-28 |