NPI | 1639329469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY23017) |
Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: CA DMH waiver) |
Enumeration Date | 2008-09-29 |
Last Update Date | 2022-07-21 |