NPI | 1629126081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2122) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY17288) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2018-04-10 |