NPI | 1902226632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY28654) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 28654) |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2014-04-21 |
Last Update Date | 2024-03-14 |