| NPI | 1578815429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017791) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 25172) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2019-05-03 |