| NPI | 1750635892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY0004592) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY33143) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2024-11-06 |