| NPI | 1639329469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY23017) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: CA DMH WAIVER) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2022-07-21 |