NPI | 1659561652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22113) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017228) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2008-08-19 |