NPI | 1659981256 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 31065) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 33208) |
Enumeration Date | 2020-08-07 |
Last Update Date | 2020-08-07 |