| NPI | 1336364066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1952) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY10331) | 
| Enumeration Date | 2007-04-16 | 
| Last Update Date | 2020-05-29 |