| NPI | 1023362167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY30651) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY30651) | |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2019-01-16 |