| NPI | 1487896379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY8501) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-08-4304) |
| 103TC0700X Psychologist Clinical (Licence: CA PSY8501) | |
| 103TF0000X Psychologist Family (Licence: CA PSY8501) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: CA PSY8501) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2011-07-27 |