NPI | 1841390788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 17865) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 17865) |
103TF0000X Psychologist, Family (Licence: CA PSY 17865) | |
103T00000X Psychologist (Licence: CA PSY 17865) | |
Enumeration Date | 2006-09-22 |
Last Update Date | 2011-10-24 |