| NPI | 1730452400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 3665-57) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY24934) |
| 103TC0700X Psychologist Clinical (Licence: MA 9408) | |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2019-05-01 |