| NPI | 1669025771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY23651) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY23651) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY23651) | |
| 103TC1900X Psychologist Counseling (Licence: CA PSY23651) | |
| 103TF0000X Psychologist Family (Licence: CA PSY23651) | |
| 103TS0200X Psychologist School (Licence: CA PSY23651) | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |