NPI | 1952970519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 32261) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 38819) |
Enumeration Date | 2021-06-18 |
Last Update Date | 2021-06-18 |