| NPI | 1689871584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 24795) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 17730 LCSW) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2015-03-18 |