| NPI | 1679730881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 20927)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID 1022)  | 
| 103TC0700X Psychologist, Clinical (Licence: NY 015889)  | |
| Enumeration Date | 2008-05-16 | 
| Last Update Date | 2019-11-18 |