NPI | 1558772772 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY9853) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC20253) |
Enumeration Date | 2014-05-09 |
Last Update Date | 2014-05-09 |