| NPI | 1053768820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2007028987) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY18132) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-10-17 |