| NPI | 1699823054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: CA CREDENTIAL) |
| Additional Taxonomies | 103TS0200X Psychologist School |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |