| NPI | 1790105070 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA Psy23542) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA Psy23542) | 
| Enumeration Date | 2014-04-24 | 
| Last Update Date | 2014-04-24 |