| NPI | 1336274919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY14960) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 1612) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2015-01-13 |