NPI | 1588005631 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY30618) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA 2012807) |
225C00000X Rehabilitation Counselor (Licence: CA 2012807) | |
Enumeration Date | 2013-07-17 |
Last Update Date | 2019-01-02 |