| NPI | 1790156370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 33829) |
| 103TC0700X Psychologist, Clinical (Licence: MA 11350) | |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2023-03-30 |