| NPI | 1730496183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 28982) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY28982) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2019-04-01 |