| NPI | 1396860904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY9767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA W117634) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |