| NPI | 1659590966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11417) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 31520) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-02-03 |