NPI | 1700256914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY26514) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY26514) |
103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY26514) | |
Enumeration Date | 2015-09-30 |
Last Update Date | 2015-12-21 |