| NPI | 1720223092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 21575) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CA 21575) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: CA 21575) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA 21575) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 21575) | |
| 103TH0004X Psychologist Health (Licence: CA 21575) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA 21575) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2013-01-22 |