| NPI | 1003103268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 32738) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY32738) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2025-07-29 |