| NPI | 1619011723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 9780) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 2990) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |