| NPI | 1063568459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA Psy15124) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014983-1) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2008-02-12 |