| NPI | 1902143274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36486) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY25453) |
| 103TC0700X Psychologist Clinical (Licence: CA PSY25453) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY25453) | |
| 103TF0000X Psychologist Family (Licence: CA PSY25453) | |
| 103TH0004X Psychologist Health (Licence: TX 36486) | |
| 103TH0004X Psychologist Health (Licence: CA PSY25453) | |
| 103TH0100X Psychologist Health Service (Licence: CA PSY25453) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA PSY25453) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-11-08 |