| NPI | 1770968737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 27223) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 016109-1) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |