| NPI | 1124301429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9449) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9449) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY19127) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2019-03-22 |