| NPI | 1881112266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY29209) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 05427) |
| 103TC0700X Psychologist Clinical (Licence: CA PSY29209) | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-07-21 |