| NPI | 1528138013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY22359) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY22359) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2017-11-16 |