| NPI | 1164755674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 25832) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA CG60197953) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2014-04-01 |