| NPI | 1023419330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005940) |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2023-04-11 |