| NPI | 1962798389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY-25481) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 225C00000X Rehabilitation Counselor (Licence: CA WAIVERED PSYCHOLOGIS) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2023-02-10 |