| NPI | 1013247089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY-3083) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ID PSY-203213) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2022-06-19 |