NPI | 1518383520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA LEP 3253) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: CA LEP 3253) |
Enumeration Date | 2014-03-14 |
Last Update Date | 2014-03-14 |