NPI | 1629322763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 24478) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2982) |
Enumeration Date | 2012-10-26 |
Last Update Date | 2012-10-26 |