| NPI | 1124351176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 27126) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA D5322936) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2016-01-11 |