| NPI | 1205117876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY26633) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY26633) | |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2015-10-05 |