| NPI | 1558436501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY 18367) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 010948) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |