NPI | 1619504925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 3897) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 3897) |
103K00000X Behavior Analyst | |
103TS0200X Psychologist, School (Licence: CA 3897) | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2020-03-25 |
Last Update Date | 2023-06-13 |