| NPI | 1780106948 |
|---|---|
| Former Name | BROOKE KIYO WATANABE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY22447) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY22447) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY22447) | |
| 103TH0004X Psychologist Health (Licence: CA PSY22447) | |
| 103TH0100X Psychologist Health Service (Licence: CA PSY22447) | |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-12-08 |