NPI | 1750611836 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22766) |
Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: CA PSY 22766) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY 22766) | |
103T00000X Psychologist (Licence: CA PSY 22766) | |
Enumeration Date | 2010-01-12 |
Last Update Date | 2012-01-12 |