| NPI | 1750557534 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY21362)  | 
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY21362)  | 
| Enumeration Date | 2008-05-01 | 
| Last Update Date | 2008-05-01 |