| NPI | 1003587858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 33037) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL 11040) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2021-12-08 |