NPI | 1619132503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22270) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020483) |
Enumeration Date | 2008-07-21 |
Last Update Date | 2018-03-17 |