| NPI | 1285947200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID PSY203711) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY25140) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2023-09-21 |