| NPI | 1003975467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 559) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY WY530) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY6897) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2019-07-04 |