NPI | 1992725451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 20722) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 20722) |
103TC0700X Psychologist, Clinical (Licence: OR 3803) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 3803) | |
Enumeration Date | 2006-07-20 |
Last Update Date | 2025-07-24 |