| NPI | 1063873123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY30955) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS018016) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2020-02-28 |