NPI | 1962973321 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61390419) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY30460) |
Enumeration Date | 2018-12-11 |
Last Update Date | 2024-08-17 |