| NPI | 1568649663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO PYT0101) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY20812) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |