NPI | 1699515379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61549569) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY31119) |
Enumeration Date | 2024-05-29 |
Last Update Date | 2024-10-25 |