NPI | 1548663545 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 29994) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA D5013000) |
Enumeration Date | 2014-10-03 |
Last Update Date | 2018-04-24 |