NPI | 1528312725 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36477) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY22450) |
Enumeration Date | 2012-11-09 |
Last Update Date | 2024-01-18 |