NPI | 1982993531 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10770) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY23172) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2019-10-01 |