NPI | 1407839012 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY19841) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY19841) |
103TF0200X Psychologist, Forensic (Licence: CA PSY19841) | |
Enumeration Date | 2005-11-29 |
Last Update Date | 2012-01-17 |