| NPI | 1972838464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY16660) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY16660) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |