| NPI | 1629785639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 33690) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810007517) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |