| NPI | 1003241480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY0004810) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY28369) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2020-02-07 |