| NPI | 1700015575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY24552) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA LCS 11634) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2012-05-03 |