| NPI | 1104105105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY33225) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103T00000X Psychologist (Licence: CA PSY22335) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2022-04-08 |