| NPI | 1942377478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95005241) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 14813) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-02-14 |