| NPI | 1568800845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3560) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 3560) |
| 103TC0700X Psychologist Clinical (Licence: CA PSY 14729) | |
| 103TF0000X Psychologist Family (Licence: NC 3560) | |
| 103TF0200X Psychologist Forensic (Licence: NC 3560) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 3560) | |
| 103TP0814X Psychologist Psychoanalysis (Licence: NC 3560) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NC 3560) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2015-06-09 |