| NPI | 1083928980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 29890) |
| Additional Taxonomies | 251S00000X |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2020-09-23 |