NPI | 1639422009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY26871) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY26871) |
103G00000X Clinical Neuropsychologist (Licence: AZ 4334) | |
103TC0700X Psychologist, Clinical (Licence: AZ 4334) | |
Enumeration Date | 2012-10-22 |
Last Update Date | 2015-03-13 |