| NPI | 1154737948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 29401) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA 29401) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 29401) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-10-24 |