| NPI | 1730120320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA CP11566) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY11566) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-10-15 |