NPI | 1649319807 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 19047) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 13037) |
Enumeration Date | 2007-02-05 |
Last Update Date | 2010-12-21 |