NPI | 1689871584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 24795) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 17730 LCSW) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2015-03-18 |