NPI | 1669789194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 23714) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 23714) |
103TA0700X Psychologist, Adult Development & Aging (Licence: CA 23714) | |
103TH0004X Psychologist, Health (Licence: CA 23714) | |
Enumeration Date | 2010-09-03 |
Last Update Date | 2011-01-10 |