| NPI | 1023301959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4906) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS017005) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2021-12-14 |