| NPI | 1578688818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004673) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 18117) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-08-23 |