| NPI | 1760561708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016887) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY21208) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2013-12-30 |