NPI | 1679995716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY26828) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021004) |
Enumeration Date | 2014-01-08 |
Last Update Date | 2016-01-25 |