| NPI | 1407109861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY5321) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY23977) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY23977) | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2021-01-27 |