| NPI | 1669919064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY34627) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY34627) | |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2023-11-22 |