| NPI | 1861633729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 22582) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017015) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2011-08-25 |