| NPI | 1073639092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 20299) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 309149) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 10750) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |