| NPI | 1023496635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 2625) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2625) |
| 103TC0700X Psychologist Clinical (Licence: CA 25759) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2021-04-23 |