| NPI | 1013319169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY28548) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2017-01-11 |