| NPI | 1508055187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY27494) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: LA 1006) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2023-08-01 |