NPI | 1467783738 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20910) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 20910) |
103TF0000X Psychologist, Family (Licence: CA PSY 20910) | |
Enumeration Date | 2010-01-26 |
Last Update Date | 2015-01-21 |