NPI | 1578770228 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY11477) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY11477) |
106H00000X Marriage & Family Therapist (Licence: CA MFT20187) | |
Enumeration Date | 2007-05-16 |
Last Update Date | 2007-12-14 |