NPI | 1699007591 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 23321) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 23321) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 23321) | |
314000000X Skilled Nursing Facility (Licence: CA 23321) | |
Enumeration Date | 2010-02-03 |
Last Update Date | 2016-02-22 |