| NPI | 1164555488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA RN211395) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY20943) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-03-30 |