| NPI | 1467768788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1387) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 30290) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2019-03-01 |