| NPI | 1760840672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 28715) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 10273) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2019-03-15 |