| NPI | 1679637037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7799) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY19686) |
| 103T00000X Psychologist (Licence: CA PSY19686) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2016-11-02 |