| NPI | 1013996040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3850) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS006016L) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2018-10-02 |