| NPI | 1164756656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: CA PSY 19462) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY 19462) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY 19462) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |