| NPI | 1629614144 |
|---|---|
| Former Name | LARISA EVANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY17813) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: CA PSY17813) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY17813) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA PSY17813) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2020-03-26 |