NPI | 1659528842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA 60712183) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY24092) |
Enumeration Date | 2008-08-19 |
Last Update Date | 2017-01-06 |