NPI | 1396963948 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY14345) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY14345) |
103TH0100X Psychologist, Health Service (Licence: CA PSY14345) | |
Enumeration Date | 2007-04-20 |
Last Update Date | 2007-07-08 |