NPI | 1861613648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY18226) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY18226) |
103TH0004X Psychologist, Health (Licence: CA PSY18226) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2007-07-08 |