| NPI | 1629352315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA D2671925) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2019-10-25 |