| NPI | 1376945741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY31339) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA PSY31339) |
| 225C00000X Rehabilitation Counselor (Licence: CA 2012897) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-12-04 |