| NPI | 1801921788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 048.0087853) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY16644) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2013-03-25 |