| NPI | 1417928227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 24238) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1255) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-08-01 |