NPI | 1417122128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 20815) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CA 20815) |
103TP2701X Psychologist, Group Psychotherapy (Licence: CA 20815) | |
Enumeration Date | 2008-04-23 |
Last Update Date | 2010-03-01 |