| NPI | 1609957315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY 3643) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 9691) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-04-05 |