NPI | 1467583419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 35086) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY19357) |
103TH0100X Psychologist, Health Service (Licence: CA PSY19357) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2021-12-09 |