| NPI | 1013258581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 415) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 415) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2021-10-05 |