NPI | 1609174077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 29921) |
Additional Taxonomies | 225C00000X Rehabilitation Counselor |
Enumeration Date | 2011-03-08 |
Last Update Date | 2018-03-02 |