| NPI | 1114041423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY23333) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY23333) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2019-04-22 |