| 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 |