| NPI | 1568692739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 19998) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 3044) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2019-09-20 |