| NPI | 1417180928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 22668) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: CA 22668) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2013-08-09 |