| NPI | 1003653080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA 4034) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 4034) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 4034) | |
| 103TC1900X Psychologist, Counseling (Licence: CA 4034) | |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-09 |