| NPI | 1063613073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA MFC30812) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY15837) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |