| NPI | 1659561652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY22113) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 017228) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2008-08-19 |