| NPI | 1639427511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY32926) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY32926) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-26 |
| Last Update Date | 2022-01-12 |