| NPI | 1053756908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05117) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY26474) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2020-09-12 |