| NPI | 1659172427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA 4559)  | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CA 4559)  | 
| Enumeration Date | 2025-03-19 | 
| Last Update Date | 2025-03-19 |