| NPI | 1609037910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA LEP2540) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA LEP2540) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA LEP254) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2012-10-03 |