| NPI | 1821165184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9705) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY23231) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-02-04 |