| NPI | 1467857474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 26053) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05220) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2014-11-03 |