| NPI | 1508868589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 21854) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 1285) |
| 103TC0700X Psychologist, Clinical (Licence: NM PSY-2026-0013) | |
| 103TC0700X Psychologist, Clinical (Licence: IA 112530) | |
| 103TC0700X Psychologist, Clinical (Licence: CO 0005631) | |
| 103TC0700X Psychologist, Clinical (Licence: HI PSY-1978-0) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2026-07-31 |