| NPI | 1174870109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 29704) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019348) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2018-12-24 |