| NPI | 1770728115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 27575) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: CA 27575) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2019-09-10 |