| NPI | 1902187040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2978-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY24063) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2012-02-17 |