NPI | 1528458957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 15688) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 15688) |
103TA0700X Psychologist, Adult Development & Aging (Licence: CA 15688) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 15688) | |
Enumeration Date | 2015-01-22 |
Last Update Date | 2015-01-22 |