| NPI | 1386789832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 28409) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NE NE 429) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-11-12 |