| NPI | 1255398871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 23877) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 0666) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2015-07-17 |