| NPI | 1558584912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA11286) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY13334) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY13334) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY13334) | |
| 103TH0004X Psychologist, Health (Licence: CA PSY13334) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2025-09-11 |