| NPI | 1215110911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 22670) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3340) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2019-06-27 |