NPI | 1952561326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 31251) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 7941669-2501) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 1050) | |
Enumeration Date | 2008-06-10 |
Last Update Date | 2019-10-18 |