| NPI | 1578121422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: CA 30597) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 30597) |
| 103TC0700X Psychologist, Clinical (Licence: CA 30597) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2020-08-02 |