| NPI | 1609650654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 133503) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 11812) |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-08-22 |