NPI | 1659758969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 32321) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
103T00000X Psychologist (Licence: CA 10807) | |
Enumeration Date | 2015-05-06 |
Last Update Date | 2021-04-15 |