| NPI | 1427334333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 1717) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 22545) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |