| NPI | 1912281635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 30219) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 2012755) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2018-07-24 |