| NPI | 1265663199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY 23728) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VT 048.0107656) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2015-03-09 |