| NPI | 1194157107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 33587) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TF0200X Psychologist, Forensic (Licence: CA 33587) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2022-11-03 |