NPI | 1821165184 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9705) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY23231) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2022-02-04 |