| NPI | 1811588189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 1912362567) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA NPF95016325) |
| Enumeration Date | 2021-01-29 |
| Last Update Date | 2021-12-16 |