NPI | 1609010057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 1317875) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 1317875) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 1317875) | |
Enumeration Date | 2009-04-29 |
Last Update Date | 2009-04-29 |