NPI | 1720333826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 18046) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CA PSY 18046) |
Enumeration Date | 2012-07-16 |
Last Update Date | 2012-07-16 |