NPI | 1588741128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 29529) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 19519) |
103T00000X Psychologist (Licence: CA PSY 19519) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |