| NPI | 1023771052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 3569) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CT 3569) |
| 103TC1900X Psychologist Counseling (Licence: CT 3569) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CT 3569) | |
| 103TH0100X Psychologist Health Service (Licence: CT 3569) | |
| Enumeration Date | 2021-10-17 |
| Last Update Date | 2021-10-17 |