NPI | 1902208580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 26557) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TX 37606) |
Enumeration Date | 2014-09-25 |
Last Update Date | 2019-04-03 |