| NPI | 1568960151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY33971) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 20066) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2023-03-14 |