| NPI | 1821133802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 3382) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY18038) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2024-03-19 |