NPI | 1700312667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 94025536) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103T00000X Psychologist (Licence: CA 94025536) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-09-06 |