| NPI | 1548647522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY27104) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: CA PSY27104) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |