NPI | 1578683363 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39051) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY19427) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2021-09-30 |