| NPI | 1588741128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY 29529) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY 19519) |
| 103T00000X Psychologist (Licence: CA PSY 19519) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |