| NPI | 1609161173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 24280) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 24280) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2016-11-20 |