| NPI | 1649200593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 18449) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP0188) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |